Here’s to you, Mom!
NOTE: In memory of John McCain, who died yesterday in the place he wanted to be, surrounded by his family. (Originally published July 20, 2015).
The four best things a doctor can say to a patient facing a health crisis, real or imagined:
One: “This isn’t serious.”
Two: “We can fix this.”
Three: “You will get better.”
Four: “If I had a magic wand, what is it you would wish for today?”
The first three “good things” are simple sentences that can do as much to alleviate pain and anxiety as any medication. They give patients hope and confidence that they will receive the care they need. The fourth “good thing” refers to a different medical situation, but it, too, provides similar comfort. Dawn M. Gross, MD uses that sentence—“If I had a magic wand, what is it you would wish for today?”– to illustrate what doctors can say when caring for terminally ill patients. You can read the entire New York Times Opionator, “The Error in ‘There’s Nothing More We Can Do’” here.
In my experience, very few doctors are comfortable telling patients that there’s nothing more to be done. Instead, because they are dedicated to fixing what’s wrong, they are reluctant to “give up” and so recommend more treatments, medications or procedures that often ruin the quality of a patient’s last days. I certainly understand how difficult it must be for a doctor to tell a patient there is nothing more to do. What Dr. Gross, a hospice and palliative care physician, knows is that there is always more to be done and that patients know exactly what more they want, if only they are asked.
When my mother’s treatment for lung cancer stopped working in the Autumn of 2012, my siblings and I needed to convince her that we didn’t think she was a “quitter” because she wanted hospice care. Once she was reassured that she wasn’t letting any of us down, she had a few wishes: to see Barack Obama re-elected (check!); to be at home with her family(check!); not be hospitalized (check!) and to die before Thanksgiving so as not to “ruin the holidays” (check!). She was efficient, my mother. As difficult it was to lose her, she got what she wanted because she was able to answer Dr. Gross’s question: “What is it you wish for today?” She had one other wish. Though Mom never much cared for alcohol, in her last years we convinced her that Cosmopolitans tasted pretty darn good and she asked that after she died, we toast her memory with a Cosmo (check!). We miss you, Mom.
